?O? - PowerPoint PPT Presentation

1 / 56
About This Presentation
Title:

?O?

Description:

Title: Patient precision testing Last modified by: user Created Date: 2/23/2006 12:20:58 PM Document presentation format: Other titles – PowerPoint PPT presentation

Number of Views:66
Avg rating:3.0/5.0
Slides: 57
Provided by: govt1151
Category:
Tags: clia

less

Transcript and Presenter's Notes

Title: ?O?


1
????????
  • ?O?
  • ??????
  • ???????????
  • ???? ???

2
??
  • ??
  • ?????????????????
  • Old Dominion University, VA. U.S.A.
  • ???????? (1990)
  • ??????
  • ????????????????
  • ?????? ??????
  • Taipei Medical University, Taipei, Taiwan
  • ??(1980)

3
??
  • ??????? ????? ???????
  • ????????????????
  • ????????(???, ??)???????
  • ????????????????????
  • ??????????????
  • ??????????????
  • ?????????????? ????
  • ???????????????
  • ??????

4
? ?
  • ????????? ???
  • ?????????? ?????
  • ????????? ?????
  • ?????????? ????
  • ????????
  • ??????? ??????
  • ??????????
  • ???????????(TAF)
  • ???????(ISO 15189) ?????

5
? ? ? ?
  • ??
  • ?????
  • ?????
  • ?????

6
????
  • ??(planning)
  • ??(organizing)
  • ??(directing), (Motivating)
  • ??(controlling)

7
Management Process Planning
  • Purposes
  • Achieve objectives
  • Implement ideas
  • Offset uncertainty and chance
  • Make things happen
  • Gain economical operation
  • Facilitate control
  • Deal with change

8
Management Process Planning
  • The basic elements of planning center around four
    points
  • Evaluation of present condition
  • The time factor
  • Collection and analysis of data
  • A hierarchy of plans with the medical laboratory

9
Management Process Planning
  • Steps
  • Specify objectives that are specific, reasonable,
    and attainable
  • Establish planning premises
  • Determining alternative courses of action
  • Selecting the best course of action
  • Implementing the plan

10
Management Process Planning
  • A good plan
  • Is based on stated objectives
  • Indicates clearly
  • What is to be done
  • How it will be done
  • When it will be done
  • Where it will be done
  • Is consistent with departmental goals
  • Is flexible

11
Management Processorganizing
  • Principles
  • Objectives
  • Authority
  • Responsibility
  • Scalar principle
  • Unity of command
  • coordination

12
Management Processorganizing
  • Staffing
  • Job description and specifications for each
    position
  • Recruitment of personnel
  • Placement of personnel
  • Inducing of personnel
  • Orienting of personnel
  • Instructing of personnel

13
Management Process Directing
  • Principles
  • Each person is unique
  • People work to satisfy their own need
  • People respond to leadership
  • Communication is essential to directing
  • Kinds
  • Issuing order
  • Delegation
  • ??????

14
Management Process controlling
  • Steps
  • Establishing standards
  • Measurement performance
  • Taking corrective action
  • A checklist for control
  • What to look for
  • Quality
  • Cost efficiency
  • Productivity

15
Management Process controlling
  • A checklist for control
  • Where to look
  • Personnel
  • Parameters of quality control
  • When to look
  • At regular times and by dropping in
  • When to act
  • When deviation from standards occurs

16
????
  • ??
  • ??????
  • ????
  • ???
  • ????
  • ???????????

17
?????
  • Deming
  • ????????????,????????????
  • Juran
  • ??????(fitness for use) ,??????????????
  • Crosby
  • ???????????
  • Feigenbaum
  • ???????,????????????
  • ???
  • ????????????????,?????????

18
?????????
  • ????
  • ????
  • ????
  • ?????????
  • ????
  • ?????
  • ?????

19
????????
  • ??
  • ??????
  • ?????????
  • ??????
  • ??
  • ???
  • ???
  • ???

20
??????
  • ??
  • ????????
  • ????
  • ??
  • ??
  • ??
  • ????
  • ??
  • ????
  • ??
  • ??
  • ???????????

21
Attitudes(??)
  • Knowledge 96
  • Hard working 98
  • Attitude 100

22
?????????
  • ????
  • ????
  • ??
  • ????
  • ??
  • ???????
  • ????
  • Precision
  • ????
  • Accuracy
  • ????

23
??????
  • ??
  • ????(turnaround time, TAT)
  • ?????
  • ?????
  • ??(??)
  • ???????
  • ????

24
????????????
  • ISO 9000
  • ISO/IEC 17025
  • ISO 15189
  • ????
  • ISO 15190
  • ISO 5725
  • ??????????????
  • CLSI..

25
(No Transcript)
26
??????
  • ??????
  • ?????????
  • ???/????????
  • ????????? LIS

?????
?????
  • ?????????
  • ????????
  • ????????
  • ?????????
  • ????

?????
2016/9/28
27
? ? ? ? ? ?
???????
?????
??????
???????
?? ???
? ?
? ?
? ?
?????????? ????? ????? ????? ???? ?????
????? ???????????? ?????????????? ??????????? ??
???? ?????????????
?????? ?????? ?????? ?????? ?????? ????????
??????? ?? ?? ??????? ?????
?????? delta check limit check ???????
????????? ??????? ??????
???? ?????? ???? ???? ????? ????
28
???????
29
???????
  • ????
  • ??????
  • ????
  • ????
  • ??????
  • ??????
  • ??????
  • ????
  • ??????
  • ????

30
???????
???
???
???
?????
???
??
??
??
??
??
??
31
Quality Control (QC)
  • Applying statistical process control to detect
    changes which might exceed quality requirements
    in the analytical procedures implemented as
    quality practices
  • Number of controls per run
  • Control rules required for each test system
  • Levey-Jennings QC charts
  • Patient data QC charts

32
????????
  • ???? (Intra-lab Quality Control) (Internal
    Quality Assessment)
  • Real time, daily, monthly, yearly
  • ???? (Inter-lab Quality Control) (External
    Quality Assessment)
  • Correlation, peer group comparison, quality
    assurance program (QAP), proficiency testing (PT)

33
(No Transcript)
34
QC Rules
 
35
(No Transcript)
36
Standard Deviation Index (SDI)
  • ??SDI?????????( peer group)??
  • ?????(accuracy)
  • ?SDI????
  • SDI(??? - ?????) / ????????

37
Precision Accuracy
  • Precision ???
  • SD ???
  • CV ????
  • CVI ??????
  • Accuracy ???
  • Mean ???
  • Bias ??
  • SDI ?????

38
????
  • ???????
  • ?????
  • ???????

39
????????????????
  • ??????
  • ??/????
  • ????
  • ????
  • ??(?)????
  • ???????
  • ????
  • ????

40
??????????
  • Traceability quality system (proficiency
    testing)
  • Accuracy precision
  • Bias SD/CV

41
??????
  • ????
  • ??
  • ??????
  • ????
  • ??
  • ???

42
Control (Westgard) rules
  • 12s
  • 13s
  • 22s
  • R4s
  • 41s
  • 10x
  • Single rule
  • Multiple rules
  • 6 Sigma (6s)

43
???????????(Quality Indicator)
  • ????????
  • ??????
  • ????????
  • ??????????
  • ???????
  • ?????
  • ?????
  • ?????
  • ?????
  • ???????

44
??QC??
???????
??????
????Level
???????
??????
??Level??
??????? ????? ?
Ca,P,Mg??? ?
Seal Piece ? ??
Rerun??QC ?
??????? ?
Sample Syring ?? ??,??,?? ?
Reagent?? ? ???? ? ????? ?
?????? ? ???? ?
TP,ALB ? ?Protein Standard
OK?? ?
Control???? ? ?? ? ?? ?
???? ? ???? ? ?? ?
_________________
TBIL,DBIL ? ?Bilirubin Standard
Finished ??,follow up ?
Parameter?? ? Chemistry ? K
Factor ?
??340nm GOT, GPT, LDH, BUN ? ?Lamp ??
Sample probe ? ??
Calibration ?? ? Standard ?
Calibration Type ?
Rinse unit ? ??
????? ????? ?
Cuvette ? ??
?? __________ ?
?? _________ ?
?? __________ ?
Mean value?? ? SD,CV?? ? TE allowable?? ? Remarks
? Keep on File ? ??____ ?
Target Value SD, TE??
??QC Chart
???? ?
45
?????????
???????
46
???????
???
???
???
???
????
????
?????
??
??
??
????
47
??????????
  • ??????
  • ????
  • ????
  • ????????
  • Delta check
  • Limit check
  • Panic check
  • ?????

2016/9/28
48
????????
  • Delta check
  • ??????
  • Limit check
  • ?????
  • ?????
  • Panic check
  • ???

49
??????
2016/9/28
50
?????????
  • ?????
  • ????
  • ??
  • ??
  • ????
  • ??
  • ??

2016/9/28
51
?????
?????????,???????????,??????????????
2016/9/28
52
?????
??????????,??????????????,?????,?????????????
2016/9/28
53
????--?????????
LIS???? ? PHS????
2016/9/28
54
????????
2016/9/28
55
?????????????????
  • ?????
  • ????
  • Ability
  • ????
  • Peer group
  • ?????
  • Third party

56
Thank You for Your Attention!
2016/9/28
Write a Comment
User Comments (0)
About PowerShow.com